Summary

One in five children is affected by asthma and wheezing
disorders in Westernized countries

New research suggests
that the pulmonary health of children worldwide could likely be
improved with the increased intake of n-3 long-chain polyunsaturated
fatty acid supplementation during mothers’ third trimesters of
pregnancy

Low n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) intake
may contribute to the increased incidence of wheeze and asthma. The
incidence of wheezing disorders has doubled in recent decades in
Westernized countries. Currently, 1 in 5 children are afflicted with
this disorder1. These changes have been concomitant with an
increase in n-6 polyunsaturated fatty acid intake from vegetable oil
consumption and a decrease in the intake of n-3 polyunsaturated fatty
acids2, particularly the long-chain polyunsaturated fatty
acids (LCPUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid
(DHA), derived primarily from cold water fish. Epidemiologic studies
have observed that a n-3 deficient diet during pregnancy increased the
risk of asthma and wheezing disorders in their offspring3.

A recent report4 of a double-blind, placebo-controlled
clinical trial has found that supplementation with n-3 LCPUFA in the
third trimester of pregnancy reduced the absolute risk of wheeze and
asthma, as well as lower respiratory tract infections in their
offspring. In this study, conducted in Denmark, 736 pregnant women in
the 24th week of pregnancy were randomly assigned to receive 2.4 g per
day of n-3 LCPUFA (55%EPA and 37% DHA) or placebo until 1 week after
delivery. This level of LCPUFA intake was 10 times the normal daily
intake in Denmark, and 20 times that in other countries, including the
U.S. and Canada. Follow up of the children continued until they were 5
to 7 years old. Diary cards were completed each day by the mothers for
the purpose of monitoring lung-related symptoms – cough, wheeze,
infections of the lower respiratory tract and trouble breathing.
After age 3, persistent wheeze was called asthma.

The Danish investigators found that n-3 LCPUFA supplementation in
the last trimester of pregnancy caused a significant 31% reduced risk
of persistent wheeze or asthma in the children. In children of mothers
who had low (lowest tertile) blood EPA and DHA, the effect of
supplementation was greater leading to a significant 54% reduction in
risk of persistent wheeze or asthma in their offspring. These positive
changes in the risk of persistent wheeze or asthma due to third
trimester fatty acid supplementation remained the same in children up
to 7 years old.

The findings of this study are interesting because it suggests that
the pulmonary health of a large number of children worldwide could
likely be improved if their mothers increase their n-3 LCPUFA intake
during the third trimester of pregnancy.

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